Individual
DR. RAJESH RAMESH GANDHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 S MAIN ST STE 303, FORT WORTH, TX 76104
(817) 702-1172
(817) 702-1605
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-7315
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
L6902
TX
2086S0102X
Surgical Critical Care Physician
Primary
L6902
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161563503
—
TX
01
—
P00413561
RAILROAD MEDICARE
—
Enumeration date
07/20/2006
Last updated
08/13/2018
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